June 21 Update

In This Week’s Update:

  • SCOTUS Decision Affirming the ACA
  • Special Enrollment Period Insures 1 Million
  • State Updates: CO, CT, NC, NJ, NV, NY, OH, OR, PA, TN, VA, WV, & WY
  • Upcoming Webinar on State Health Equity Measurement
  • State Employee Health Plans and Cost Containment Strategies
  • Health Sector Economic Indicators


SCOTUS Affirms the ACA Again

In a 7-2 decision, the United States Supreme Court dismissed a challenge to the Affordable Care Act, leaving the law intact. In the majority opinion, the justices note that the plaintiffs did not have standing to bring forth the challenge.


Related resource:  Supreme Court Rejects ACA Challenge; Law Remains Fully Intact


Special Enrollment Period Adds 1 Million to HealthCare.gov Plans

CMS issued its fourth enrollment snapshot for the COVID-19 special enrollment period (SEP) in the 36 states using HealthCare.gov. As of May 31, more than 1.2 million people had newly selected a marketplace plan during the SEP. The ongoing enrollment extends through August 15, and is expected to add to the record high of 31 million people enrolled in marketplace or Medicaid coverage. 


Upcoming SHVS Webinar

Highlights of the Buying Value Benchmark Repository: Innovative Homegrown Measures

Tuesday, June 22 2:00 to 3:00 p.m. ET

States are responsible for ensuring that their Medicaid programs deliver high-quality, high-value care, but there are not always nationally-endorsed measures focused on states’ areas of interest. This is especially true for equity-related measurement. State Health and Value Strategies is hosting a webinar to explore innovative measures that states have developed to address their program priorities. The Buying Value suite of resources is designed to support state use of performance measures for assessing and improving value with managed care plans and accountable provider entities. The webinar will be facilitated by experts from Bailit Health and will feature state officials discussing their experiences developing and implementing homegrown measures included in the Buying Value Repository. Register here for the event. 


COVID-19 Updates

  • New Jersey – Governor Phil Murphy signed legislation offering an additional year of special education to students with disabilities, noting that “The pandemic has been especially hard on students with disabilities who rely on school programs to ensure they have the skills and services they need to be successful following graduation. By providing an additional year for students who will otherwise age out allows us to acknowledge the unique impact of the pandemic on these students and help secure a better future for them and their families.
  • New York – Governor Andrew Cuomo announced 12 new pop-up vaccination sites will open in areas where zip code data shows the vaccination rate is significantly lower than the statewide average.
  • North Carolina The North Carolina Department of Health and Human Services (DHSS) is launching an expanded COVID-19 screening testing program to support public, charter and private K-12 schools in protecting students and staff from the spread of COVID-19. The program will launch in fall 2021 and schools can register to participate beginning in early July. DHHS also announced the state is expanding availability of its at-home COVID-19 test collection. Any North Carolina resident may receive a Pixel by Labcorp® COVID-19 PCR Test Home Collection Kit that is shipped overnight directly to their homes at no cost. Tests can be used on people age 2 and up.
  • Ohio – Governor Mike DeWine announced the end of Ohio’s COVID-19 pandemic emergency. He urged those who have not yet received the vaccine to find a clinic near them using gettheshot.coronavirus.ohio.gov. Governor DeWine also announced that 3,428,514 vaccinated adults entered for a chance to win $1 million and 150,187 vaccinated youth entered for a chance to win a college scholarship in this week’s Ohio Vax-a-Million drawing. This is an increase from the 66,311 adult entries and 6,583 youth entries two weeks ago. 


Other State Updates

  • Colorado – Governor Jared Polis signed two health-related bills into law this week. HB21-1232 requires the establishment of a standardized health benefit plan to be offered alongside those sold on the state-based marketplace and requires private insurance companies to reduce premiums by 15 percent by 2025. SB21-175 establishes a prescription drug affordability review board and directs the board to review the affordability of certain drugs and establish upper payment limits for certain drugs.
  • ConnecticutGovernor Ned Lamont signed legislation declaring racism a public health crisis and establishing a Commission on Racial Equity in Public Health to document and make recommendations to decrease the effect of racism on public health. The law also requires state agencies to collect race, ethnicity, and language data using a standard set of categories based on the demographics of Connecticut.
  • NevadaGovernor Steve Sisolak signed legislation establishing a public option plan in the state. The legislation includes a requirement that managed care organizations offer plans on the marketplace, intending to reduce the plans’ average premium costs by 15 percent over four years. The public option plans will be offered beginning in 2026. 
  • OregonThe Oregon Health Authority published the Oregon School-Based Health Centers Status Report for 2021, which finds that school-based health center use fell from 130,586 visits during the 2018-2019 school year to 121,144 in the 2019-2020 school year, a seven percent decrease. But behavioral health visits and client counts slightly increased during that time, from 6,466 clients and 43,982 visits in 2018-2019 to 6,537 clients and 44,258 visits in 2019-2020.
  • Pennsylvania – The Department of Drug and Alcohol Programs announced the availability of $7 million in funding for entities providing pregnancy support services or making referrals to address the needs of pregnant and postpartum women with substance use disorder. The grants are part of $55 million in federal funding awarded to Pennsylvania through Substance Abuse and Mental Health Services Administration Substance Abuse Prevention and Treatment Block Grant Program COVID-19 Supplemental Awards. 
  • TennesseeTennCare released a Medicaid managed care request for proposals to provide full-risk managed care services to members enrolled in Medicaid, CHIP, and dual-eligible special needs plans. Proposals are due August 31, 2021, with awards expected on October 8. The state intends to contract with three Medicaid plans. Twelve billion dollars of annual contracts will be implemented on January 1, 2023, and run for three years with seven one-year renewal options.
  • VirginiaThe Virginia Medicaid agency is soliciting recommendations on the best ways to invest the American Rescue Plan Act funding to support state COVID-related home-and community-based services (HCBS) needs or activities aimed at building capacity in the broader Medicaid HCBS system.
  • West VirginiaThe West Virginia Department of Health and Human Resources, Special Supplemental Nutrition Program for Women, and a health technology company that provides 24/7 infant feeding support to new and expecting parents announced the first Diversity in Lactation Consulting scholarship winner. The winner will receive $1,000 to cover the cost of the exam required to become an International Board-Certified Lactation Consultant. The scholarship is designed to improve diversity among lactation consultants.
  • Wyoming – The Wyoming Department of Health announced changes to breast, cervical, and colorectal screening services. The Wyoming Department of Health announced changes to breast, cervical, and colorectal screening services. A new program covers the cost of breast, cervical, and colorectal cancer screenings for eligible Wyoming residents. Also, cervical cancer screening services will expand coverage to include those who are considered underinsured.



Unleashing the Giant: Opportunities for State Employee Health Plans to Drive improvements in Affordability

The agencies that purchase health benefits for state employees are uniquely situated to tackle health care costs. They are often the largest employer purchaser in their state and can potentially exert considerable pressure on insurers and providers. A new study by the Georgetown Center on Health Insurance Reforms scans the landscape of state employee plans around the country, assesses a range of cost containment strategies implemented by state health employee plans, and shares lessons for building on those that appear most promising. 


Related resource: State Employee Health Plans and Cost Containment Initiatives



June 2021 Health Sector Economic Indicator Briefs

With support from the Robert Wood Johnson Foundation, Altarum released its monthly Health Sector Economic Indicators (HSEI) briefs analyzing the most recent data available on health sector spending, prices, employment, and utilization. National health spending in April 2021 was 32.4 percent higher than in April 2020, reflecting the recovery from the lows of the COVID-19 pandemic. Additionally, growth in the overall Health Care Price Index remained mostly steady in May, with prices 2 percent higher than they were a year ago. Hospital and physician services prices continued to be the two fastest-growing major categories, increasing 3.6 percent and 3.1 percent year over year, respectively. Nursing home facility and home health care price growth has slowed significantly over the past few months, now up only 2.1 percent and 1.5 percent respectively in May. Finally, health care added a modest 22,500 jobs in May (mostly in ambulatory care settings), and employment in the health care sector is now at the level it was at the end of 2020.